The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial.
We report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure.This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5662220?pdf=render |
| _version_ | 1818552924573270016 |
|---|---|
| author | Dirk Schädler Christine Pausch Daniel Heise Andreas Meier-Hellmann Jörg Brederlau Norbert Weiler Gernot Marx Christian Putensen Claudia Spies Achim Jörres Michael Quintel Christoph Engel John A Kellum Martin K Kuhlmann |
| author_facet | Dirk Schädler Christine Pausch Daniel Heise Andreas Meier-Hellmann Jörg Brederlau Norbert Weiler Gernot Marx Christian Putensen Claudia Spies Achim Jörres Michael Quintel Christoph Engel John A Kellum Martin K Kuhlmann |
| author_sort | Dirk Schädler |
| collection | DOAJ |
| description | We report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure.This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress syndrome were eligible for study inclusion. Patients were randomly assigned to either therapy with CytoSorb hemoperfusion for 6 hours per day for up to 7 consecutive days (treatment), or no hemoperfusion (control). Primary outcome was change in normalized IL-6-serum concentrations during study day 1 and 7.97 of the 100 randomized patients were analyzed. We were not able to detect differences in systemic plasma IL-6 levels between the two groups (n = 75; p = 0.15). Significant IL-6 elimination, averaging between 5 and 18% per blood pass throughout the entire treatment period was recorded. In the unadjusted analysis, 60-day-mortality was significantly higher in the treatment group (44.7%) compared to the control group (26.0%; p = 0.039). The proportion of patients receiving renal replacement therapy at the time of enrollment was higher in the treatment group (31.9%) when compared to the control group (16.3%). After adjustment for patient morbidity and baseline imbalances, no association of hemoperfusion with mortality was found (p = 0.19).In this patient population with predominantly septic shock and multiple organ failure, hemoadsorption removed IL-6 but this did not lead to lower plasma IL-6-levels. We did not detect statistically significant differences in the secondary outcomes multiple organ dysfunction score, ventilation time and time course of oxygenation. |
| first_indexed | 2024-12-12T09:19:26Z |
| format | Article |
| id | doaj.art-f831a791d9f447269769570af476bc00 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T09:19:26Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f831a791d9f447269769570af476bc002022-12-22T00:29:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011210e018701510.1371/journal.pone.0187015The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial.Dirk SchädlerChristine PauschDaniel HeiseAndreas Meier-HellmannJörg BrederlauNorbert WeilerGernot MarxChristian PutensenClaudia SpiesAchim JörresMichael QuintelChristoph EngelJohn A KellumMartin K KuhlmannWe report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure.This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress syndrome were eligible for study inclusion. Patients were randomly assigned to either therapy with CytoSorb hemoperfusion for 6 hours per day for up to 7 consecutive days (treatment), or no hemoperfusion (control). Primary outcome was change in normalized IL-6-serum concentrations during study day 1 and 7.97 of the 100 randomized patients were analyzed. We were not able to detect differences in systemic plasma IL-6 levels between the two groups (n = 75; p = 0.15). Significant IL-6 elimination, averaging between 5 and 18% per blood pass throughout the entire treatment period was recorded. In the unadjusted analysis, 60-day-mortality was significantly higher in the treatment group (44.7%) compared to the control group (26.0%; p = 0.039). The proportion of patients receiving renal replacement therapy at the time of enrollment was higher in the treatment group (31.9%) when compared to the control group (16.3%). After adjustment for patient morbidity and baseline imbalances, no association of hemoperfusion with mortality was found (p = 0.19).In this patient population with predominantly septic shock and multiple organ failure, hemoadsorption removed IL-6 but this did not lead to lower plasma IL-6-levels. We did not detect statistically significant differences in the secondary outcomes multiple organ dysfunction score, ventilation time and time course of oxygenation.http://europepmc.org/articles/PMC5662220?pdf=render |
| spellingShingle | Dirk Schädler Christine Pausch Daniel Heise Andreas Meier-Hellmann Jörg Brederlau Norbert Weiler Gernot Marx Christian Putensen Claudia Spies Achim Jörres Michael Quintel Christoph Engel John A Kellum Martin K Kuhlmann The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. PLoS ONE |
| title | The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. |
| title_full | The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. |
| title_fullStr | The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. |
| title_full_unstemmed | The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. |
| title_short | The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. |
| title_sort | effect of a novel extracorporeal cytokine hemoadsorption device on il 6 elimination in septic patients a randomized controlled trial |
| url | http://europepmc.org/articles/PMC5662220?pdf=render |
| work_keys_str_mv | AT dirkschadler theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christinepausch theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT danielheise theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT andreasmeierhellmann theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT jorgbrederlau theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT norbertweiler theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT gernotmarx theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christianputensen theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT claudiaspies theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT achimjorres theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT michaelquintel theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christophengel theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT johnakellum theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT martinkkuhlmann theeffectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT dirkschadler effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christinepausch effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT danielheise effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT andreasmeierhellmann effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT jorgbrederlau effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT norbertweiler effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT gernotmarx effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christianputensen effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT claudiaspies effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT achimjorres effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT michaelquintel effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT christophengel effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT johnakellum effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial AT martinkkuhlmann effectofanovelextracorporealcytokinehemoadsorptiondeviceonil6eliminationinsepticpatientsarandomizedcontrolledtrial |